The need for a lingual arch wire with supports thereof has long been recognized in dentistry. This strong wire, when supported on molars, has a variety of uses, such as to:
1. Maintain space when teeth are prematurely lost; PA1 2. Retain arch size during and after orthodontic therapy; PA1 3. Serve as a base for attaching auxiliary wires for tooth movement; PA1 4. Provide anchorage, total or supplemental, for tooth movement; and PA1 5. Regulate molar movement in all planes. PA1 1. No special pliers are needed to construct or manipulate the lingual arch wire; PA1 2. The lingual arch wire is inserted and removed with respect to the occlusal direction; PA1 3. The horizontal orientation of the bracket eliminates lingual arch wire and other installation breakage; PA1 4. The snap-lock is positive and retains the lingual arch wire firmly in the bracket in its fixed-removable position; PA1 5. The snap out unlocking of the lingual arch wire is simple and easy; PA1 6. The lingual arch wire may be formed and accurately placed in the patient's mouth while the dentist remains by the dental chair; PA1 7. Laboratory procedures are eliminated; and PA1 8. These mirror image orthodontic brackets control molar tooth movement in all geometric planes.
The lingual arch wires and their supports, which are used currently and have been employed by orthodontists for over three quarters of a century, should not be confused with the recent innovation of placing attachments of orthodontic brackets on the lingual surfaces of all the teeth in a dental arch to be regulated. These appliances are referred to as "Lingual Appliances".
Originally, the round lingual arch wire was fixed, by soldering it to molar bands, in turn cemented to molars. To make adjustments of the lingual arch wire or to add auxiliaries to it, the molar bands to which it was soldered had to be removed and recemented each time. This time consuming and cumbersome approach to manipulating the lingual arch wire resulted in a search for orthodontic devices which could be designed to secure the lingual arch wire in a very fixed way, and Yet have it be quickly and easily removed.
Such orthodontic devices were said to make the lingual arch wire "fixed-removable". One of the first devices for a "fixed-removable" lingual arch wire was designed by John V. Mershon. The Mershon device was a bracket which consisted of a half round tube soldered vertically to a molar band. Then a half round wire dimensioned to fit the half round tube was soldered on the lingual arch wire. Thereafter, when the half round wire was fitted to the half round tube on the molar band, one end of the lingual arch wire was secured.
Later, Dr. A. Edel formed a lingual arch wire receiving bracket, which has two vertical round tubes soldered parallel to each other on the molar band. A round wire staple was adapted to fit simultaneously into the vertical tubes. This staple was then soldered to the lingual arch wire and then used in securing one end of the lingual arch wire.
Walter H. Ellis attempted to improve on Dr. Edel's bracket by using a specially formed continuous arch wire, thus eliminating a soldering operation. An oval tube was soldered vertically to the lingual of the molar band. The terminal end of the lingual arch wire was fabricated with a short, closed loop, which fitted in the vertical oval tube.
All of these prior devices, inclusive of their brackets did function, but their negative factors were: the difficulty of their fabrication, and their frequency of breakage, which was all too frequent.
Spencer R. Atkinson designed a lingual arch bracket with a horizontal sheath, which is currently available. The terminal end of the lingual arch wire was recurved on itself and then wa retained by friction in the horizontal sheath. The negative factors were and are: special pliers are needed to form the recurved end; and, a dentist may experience difficulty in placing and removing the recurved ends in the respective horizontally oriented sheath.
The Gashgarian Palatal Bar described by Fredrico V. Tent has a horizontal molar sheath similar to Atkinson's bracket. The arch wire is oriented palatally after it leaves the sheath. The arch wire is prefabricated and is presently available in four different sizes.
Wilson has made and still makes a prefabricated lingual arch wire with closed loops. These closed loops fit precisely into two vertical tubes on respective molar bands. They may be obtained from Rocky Mountain Orthodontic Supply Company in Denver, Co.
Although these prior brackets and devices were and are effective in positioning and securing lingual arch wires, a simple and more efficient approach to attaching a lingual arch wire to the molars is still needed.